I’m a recovering alcoholic with 17+ years of sobriety. The first “pill-head” I met was in rehab in 1988, a man injured in a car accident who got hooked on painkillers during his recovery. Opioid abuse has been around for much longer than the current “crisis”. Photographer Larry Clark documented opioid addiction in the American Midwest in the 1960s and early 1970s in his classic work, Tulsa, but it was around long before that.
So how does it reflect on the country?
In other countries discussions about problems are discouraged – even illegal. In the 12 Steps the first step is admitting you have a problem. Americans are extremely open about admitting our problems and don’t realize that everyone isn’t. The press reports on it regularly. In some countries such reporting is discouraged or banned outright. So I believe it “reflects” our openness based on our fundamental right to free expression.
We disagree on the causes of the problem. One writer blames doctors. Another blames pharmaceutical companies. 330 million of us so you can expect 330 million opinions. Our disagreements reflect our diversity of opinion – a diversity that is rare in most countries including some I have lived in.
Who do I blame? As an addict myself I blame the addicts but I recognize a complex problem like opioid addiction has complex sources, so I understand there is plenty of blame to go around. Recently Americans have taken a shine to the cult of victimhood and it may seem heartless of me to blame the junkies themselves for their plight, but they bear ultimate responsibility for their own lives. Staying clean is a constant struggle. It’s not easy but neither is Life. People need to wake the f*** up and stop expecting someone else to fix their problems. The cult of victimhood discourages this which is why I fight it.
The corporate takeover our healthcare system makes the problem worse. Doctors are now paid according to the number of patients they see, discouraging them from spending time with a patient in order to accurately diagnose their conditions, encouraging them to throw meds at a patient. The corporatization of health care also has patients rating their experiences with doctors so that doctors who refuse a prescription for pain meds risks getting a complaint or a bad review in social media.
Treating addicts takes time. You can’t fix a junkie with a pill – in fact Medicine doesn’t know how to fix an addict at all. A primary care doctor can’t spend more than 10 minutes with an addict who walks into their office, especially when it will take 20 minutes to document the visit in their electronic health record.
Your New Health Team
We treat addiction as a crime and continue to ban drugs even though we know the bans don’t work. This reminds me of the debtors prisons common in the 17th and 18th centuries. The idea that entire families would be imprisoned for debts seems cruel to us, yet we jail addicts for crimes directly related to their addictions such as possession and petty theft. In recent years we have made our prison de facto addiction treatment facilities, making cops and jail personnel into drug counselors.
As for bans there is an inverse relationship between heroin and pills. Cut an addicts access to pills and they resort to heroin. If pills are plentiful demand for heroin goes down.
We refuse to face the fact that not everyone becomes addicted to a drug, and those that do are going to get their fix no matter what. What do we do as a society? How about offering addicts drugs and safe places to use them?
We are fundamentally optimistic and open to change. America is a big country and it has big problems. That doesn’t stop us from arguing about them, searching for solutions and trying to solve them. Not all places in the world are like this and some actively resist change. America is dynamic, and if there’s a problem we will eventually find the correct solution after we try all others to paraphrase Winston Churchill.
Photo by linmtheu